There are an overwhelming range of emotions and feelings when discussing suicide. It is even more disturbing when suicide becomes a part of a political agenda. The idea that gay teens are at a higher risk for suicide may be seen in this context. The following is written to help explain with clarity and a purpose to meet the needs of all of the youth who struggle with suicide.

Suicide is usually a story of misperceptions and misunderstandings, of feelings of despair and lack of control; it cannot be attributed simply to having a difficult life. And it has no place on anyone’s political agenda, no matter how worthy. (Schaffer, Political Science, p.116)

High-quality care depends on sound scientific research to determine the causes of suicide and to determine effectiveness and safety interventions. Research on the relationship between sexual orientation and suicide, however, is limited both in quantity and quality. (Muehrer, Suicide and Sexual Orientation: A Critical Summary of Recent Research and Directions for Future Research, p.72)

Defining terms

One of the largest concerns in studies of suicide is the defining of terms associated with suicide. This is also a problem in homosexual studies. People are homosexual, gay, and queer. Each term has different meanings when used by individuals in various contexts. At one time those advocating for homosexuality used sexual preference and now it is sexual orientation to describe erotic attraction between individuals. Whether the attraction is between members of the same sex or to the opposite sex.

Studies and discussion of suicide are hampered by the lack of a standard nomenclature, i.e. definition of terms. There is a no question understanding the meaning of suicide. Nor is there confusion with suicide ideation, thinking about suicide. But there is a problem with determining the seriousness of these thoughts, because they are self-reported. In between these two terms are the ideas of suicidal threats, behavior, acts, and attempts. Again, questions arise concerning the seriousness of these actions, for example a suicide attempt resulting in no injuries and an attempt resulting in injuries. Both are suicide attempts, but in the reporting of them may be of concern. Attempts often are self-reported and without injuries requiring intervention by others may lead to questions of the validity of the attempt. Many people, who only desire attention, may use suicide as a way of receiving attention. Suicide, from ideation to completion is difficult for those seeing it as a possible solution to a problem, and equally difficult for the ones seeking to help.

Historical Perspective

Though his findings were greatly overshadowed by a lawsuit brought six students who charged him with obscenity (he was found guilty and made to pay a fine and costs), he managed to conduct the first large-scale gay survey, the scientific technique upon which the gay movement was to continually re-establish its credentials with increasing frequency and specialization over the next century. Hirschfeld’s two ultimate justifications for his organization and his activist tactics and pursuits also bore a striking resemblance to those used in continuing the fight he started. The first was to establish as scientific fact that the homosexual was born, not made, and so was beyond the scope of a legal system that could punish people for what they did, not who they were. The second was to prevent teenage suicide. (Archer, The End of Gay and the death of heterosexuality, p.76)

The idea of a homosexual’ being a distinct type of a person was first advocated in the 1860s in Germany. It was by those advocating for legal rights for homosexuals. One early German leader for the emancipation of homosexuals was Magnus Hirschfeld (1868-1935). Of the early homosexual rights advocates, Hirschfeld’s career and legacy presents in retrospect as many errors and failures to be shunned as achievements to emulate. He was homosexual himself like many of the other early advocates for homosexual’ rights. His view of homosexuality was similar to that of Ulrichs. Homosexuality was innate and biological in nature. Homosexuals were a third sex, resulting from a hormonal cause. It resulted in a preponderance of the female in the male and the male in the female. Hirschfeld never put forth a coherent scientific explanation of homosexuality’ and his works were rejected.
In 1933 the Nazis burned his works and research. Hirschfeld’ legacy was tarnished by serious lapses of professional ethics. He was accused of selling worthless patented medicines. The most serious lapse was the allegations that he extorted money from some famous Germans who had in good faith furnished him with materials revealing the intimate (and incriminating) sides of their lives. Hirschfeld also conducted two polls of high school boys and male factory workers. The poll of the high school boys resulted in legal troubles for Hirschfeld.

One researcher over time changed his mind about homosexual youth and suicide.

Savin-Williams from Cornell University in two articles published in the Journal of Consulting and Clinical Psychology, the first in 1994 and the second in 2002. They come to opposite conclusions as to the relationship between sexual orientation and suicide. In his second article, he no longer concludes that homosexual youth are at an increased risk for suicide. Note the titles of the two articles also. Below are quotes, including titles from the two articles.

1994: The empirical documentation is of one accord: The rate of suicide among gay male, bisexual, and lesbian youths is considerably higher than it is for heterosexual youths. (Savin-Williams, Verbal And Physical Abuse as Stressors in the Lives of Lesbian, Gay Male and Bisexual Youth: Associations With School Problems, Running Away, Substance Abuse, Prostitution, and Suicide. p. 266).

2002: Consistent with previous findings, results from the studies indicate that sexual - minority youths report higher suicide attempts than do heterosexual youths. However, because many of these reports were false and because life - threatening true attempts did not vary by sexual orientation, the assertion that sexual - minority youths as a class of individuals are at increased risk for suicide is not warranted. (Savin-Williams, Suicide Attempts Among Sexual - Minority Youths: Population and Measurement Issues. p. 989)

Source of the Gay Teen Suicide Myth

1989 Department of Health and Human Services (HHS) Report of the Secretary’s Task Force on Youth Suicide and Paul Gibson

The gay teen suicide myth controversy began with this government task force formed to gather papers on youth suicide. There were 50 background papers addressing a very broad range of issues related to youth suicide and suicidal behavior. Two of them by Gibson and Harry addressed the issue of sexual orientation. The authors of these two papers were not employed by the federal government and neither of these papers presented any original research on completed suicides and sexual orientation. Gibson’s paper was not based on an actual study but rather on a review of non-probability (non-random) studies and agency reports of lesbian and gay adolescents and adults conducted between 1972 and 1986. In formulating his conclusions Gibson took from Kinsey’s study that 10% of the American population is homosexual, which itself is a myth, acknowledged even by homosexual advocates. The views in the papers were of the authors. There have been questions raised as whether the papers submitted by Gibson and Harry were accepted by the task force and included in the final recommendations of the task force. Also, it has been noted that these two papers were not submitted for the rigorous peer review that is required for publication in a scientific journal.

Gibson’s most often cited claims are:
(1) 30% of the youth suicides are homosexual.
(2) Homosexual youths are 2 to 3 times more likely to attempt suicide than their heterosexual peers.
(3) Suicide is the leading cause of death of among homosexual youth.
(4) Gay suicide is caused by the internalization of homophobia’ and violence directed towards homosexual youth.

In my psychiatric practice I have found that the government statistics so frequently cited were not prepared by the government and are not statistics. They are estimates based on a projection in a paper prepared for the task force report. The paper was never subjected to rigorous peer review that is required for publication in a scientific journal, and contained no new research findings. The estimate that as many as thirty percent of youth suicides are gay was based on the results of several studies that reported high rates of suicidal feelings and behavior by gays and on Kinsey’s conclusion that gays make up ten percent of the population. (Schaffer, Political Science. p.116)

There are homosexual advocates who also acknowledge the shortcomings presented by Gibson in his paper.

Although this information has been reported in many articles and texts about lesbian and gay youth, it is not based on an actual study but rather on a review of non-probability (non-random) studies and agency reports of lesbian and gay adolescents and adults conducted between 1972 and 1986. The review was done by Paul Gibson, a clinical social worker, as one of 50 papers or studies commissioned by the Secretary’s Task Force on Youth Suicide, which was established in 1985 in response to growing rates of youth suicide and concluded its work in 1987. (Ryan and Futterman, Lesbian and Gay Youth, p.61)

Unfortunately, Gibson’s conclusions were based on very limited empirical data, and rely heavily on reports from organizations that may draw individuals with mental health problems. (D’Augelli and Hershberger. Lesbian, Gay, and Bisexual Youth in Community Settings: Personal Challenges and Mental Health Problems. p.424)

Governor Weld of Massachusetts by executive order in 1992 established the Commission on Gay and Lesbian Youth. He did so using this information in Gibson’s paper. The Massachusetts Safe Schools Project, Gay and Straight Alliances in schools are also a result of this faulty information on homosexual youth suicides.

Studies report that homosexuality per se is not directly related to suicide.

In this sample, bisexuality or homosexuality per se was not associated with self-destructive acts. Most of the subjects did not attempt or plan suicide. (Remafedi MD, MPH, Gary, James A Farrow, MD and Robert W Deisher, MD. Risk Factors for Attempted Suicide in Gay and Bisexual Youth. p.495)

Of the ten studies, 6 explored risks for suicide by comparing attempters and nonattempters. They found that suicide attempts were neither universal nor attributable to homosexuality per se, but were significantly associated with gender nonconformity, early awareness of homosexuality, stress, violence, lack of support, homelessness, substance abuse, or other psychiatric symptoms. (Remafedi, Gary, MD, MPH. Sexual Orientation and Youth Suicide, p.1291)

"It is important to note that suicide risk among homosexual students was not attributed to homosexuality per se, on the basis of the absence of such association in the females." (Remafedi, "The Relationship Between Suicide Risk and Sexual Orientation: Results of a Population-Based Study," p. 59)

However, it seems clear that only a small portion of suicides were openly gay. We found no evidence that the risk factors for suicide among gays were any different from those among straight teens. (Shaffer, Fisher, Hicks, Parides, and Gould, Sexual Orientation in Adolescents Who Commit Suicide. p.70)

The findings in this study suggest that there may be few if any differences between young gay and straight males who commit suicide. (Rich, Fowler, Young, and Blenkush, San Diego Suicide Study: Comparison of Gay to Straight Males. p.452)

In the present study, the researchers examined factors related to depression, hopelessness, and suicidality in gay, lesbian, and bisexual adolescents, compared with demographically similar heterosexual adolescents. Sexual minority adolescents reported greater depression, hopelessness, and past and present suicidality than did heterosexual adolescents. However, when controlling for other psychosocial predictors of present distress, significant differences between the 2 samples disappeared." (Safren and Heimberg. Depression, Hopelessness, Suicidality and Related Factors in Sexual Minority and Heterosexual Adolescents, p.859)

In the few studies examining risk factors for suicide where sexual orientation was assessed, the risk for gay or lesbian persons did not appear any greater than among heterosexuals, once mental and substance abuse disorders were taken into account. (National Institute of Mental Health web site, www.nimh.nih.gov/research/suicidefaq.cfm)

Limitations in the research literature

"This critical summary has identified several limitations in the research literature on suicide and sexual orientation: a lack of consensus on definitions of fundamental terms such as "suicide attempt" and "sexual orientation," uncertain reliability and validity of measures for these terms, nonrepresentative samples, and a lack of appropriate control groups, among other limitations. These limitations prevent accurate conclusions about: (1) completed or attempted suicide rates among gay/lesbian youth in the general population or in clinical populations, (2) comparsions of completed or attempted suicide rates between gay/lesbian youth and nongay youth in the general poulation, (3) the potential role that sexual orientation and related factors may play in suicidal behavior independently of well-established risk factors such as mental and substance abuse disorders." (Muehrer, "Suicide and Sexual Orientation: A Critical Summary of Recent Research and Directions for Future Research, p. 79)

What the studies do report about homosexual youth and suicide.

Those homosexual youth, who do attempt suicide:

(1) Express more gender nonconformity i.e. feminine gender role concepts.
(2) Became aware of their same-sex attractions at an early age.
(3) Labeled themselves as homosexual and had their first sexual experiences at younger ages than their peers.
(4) Homosexual and heterosexual youth who attempt suicide are comparable in the following ways:
(a) Both have family problems.
(b) Both report drug and alcohol abuse.
(c) Both have conflicts with the law and have been arrested.
(d) Both suffer from depression or other mental illness issues.
(e) Both experience either physical or sexual abuse.
(f) Both have family members or friends who attempted or committed suicide.

"Prior studies of bisexual/homosexual male adolescents have found that increased rates of suicides attempts were not universal, but were associated with particular risk factors, such as self-identification as a homosexual at younger ages, substance abuse, female gender role, family dysfunction, interpersonal conflict regarding sexual orientation, and nondisclosure of sexual orientation to others." (Remafedi, "The Relationship between Suicide Risk and Sexual Orientation," p. 59)

Remafedi from the University of MN who is a homosexual advocate, in a 1991 study with others found this relationship between homosexual self-labeling and suicide.

For each year’s delay in bisexual or homosexual self-labeling, the odds of a suicide attempt diminished by 80 percent. These findings support a previously observed, inverse relationship between psychosocial problems and the age of acquiring a homosexual identity. (Remafedi, Farrow, Deisher, Risk Factors for Attempted Suicide in Gay and Bisexual Youth. p.495)

This relationship should remain foremost in out attempts to provide school based sex education and meeting the needs of young people struggling with both gender identity confusion and same-sex attractions.

Bibliography

Archer, Bert. The End of Gay (and the death of heterosexuality). Thunder’s Mouth Press. New York, 2002.